U.S. Zika Funding: A Race Against the Rain

Here in Nicaragua, the rains of May have arrived. Five months of intense heat, drought and dust disappear in an instant. Sweltering, sleepless nights turn cool and breezy. The landscape greens, farmers whisper thankful prayers and children splash in puddles.

But each raindrop has a dark side, as the rains increase the danger from mosquito-borne illnesses such as Dengue, Chikungunya, and the dreaded newcomer, Zika.

Communities surrounding OneWorld Health's rural clinics watch with horror as the dark cloud of Zika spreads over South and Central America. There have so far been less than 200 confirmed cases here in Nicaragua, but just hours ago, the national government issued a “red alert” about rising numbers of Zika and Dengue.

Over 30% of our clinics’ rural, low-income patients contract mosquito-borne illnesses each year. Dengue and Chikungunya are more debilitating; deadly, even, but everyone’s worry is Zika. In our women’s health programs, the joy of a positive pregnancy test is now burdened with fearful, worried questions about prevention and risk.

As public health workers, it’s frustrating not knowing more. Infant microcephaly is connected to Zika, but we can’t confirm when a mother or fetus is at highest risk, or what percentage of cases end up with complications. We know four out of five people infected with Zika never show symptoms; that Zika can be passed through sexual contact (ie; spread without mosquitos). Even more distressingly, the CDC just issued a report saying it’s likely the nightmare of microcephalic birth defects are just the “tip of the iceberg” concerning Zika’s long-term effects in child development.

In our clinics, we make sure people with few resources have access to quality primary care. We educate surrounding communities on mosquito-borne illness prevention methods. Eliminate standing water. Apply mosquito repellant. Install bednets and window screens if possible. Wear long sleeves outdoors. We coordinate with the local Ministry of Health as they fumigate barrios and go door-to-door eliminating potential mosquito breeding grounds.

All of that is good, solid public health protocol, proven effective in lowering numbers of mosquito-borne illness. But none of those measures prevented Chikungunya from spreading widely and rapidly over the last few years, and Zika follows the exact same epidemiological highways. Realistically, only well-funded research will help us know how to arrest the spread of the Zika virus and take better care of affected patients. That type of research is expensive.

Vaccines are in the late stages of development, and encouraging advances are being made - like genetically modifying mosquito populations - but without increased funding, epidemiological weapons like those can’t be tested, scaled, and distributed fast enough to halt the expected surge in cases. Zika caught the world off guard, the rain is coming, and there’s just not enough money available to fight it. Yet.

President Obama recently re-allocated $500 million in emergency health funding to use against the Zika threat. Lawmakers introduced another bill to release an additional $1.9 billion to study and fight the virus. Other countries are responding similarly. Calls for U.S. and international funding aren’t just emergency aid packages for “needy” Latin American nations. As with the faster-burning but equally terrifying Ebola virus, it is absolutely in the United States’ best interest to combat and contain Zika where it is found, before it overflows from Central and South America, becoming endemic in the mosquito-rich southern U.S. and Great Lakes regions.

Florida Governor Rick Scott, who recently declared states of emergency in four of Florida’s counties due to Zika, has aptly compared the virus to an approaching hurricane. Some in Congress want to slow and more tightly restrict the proposed funding, which seems like a good idea unless you’re a pregnant woman in New Orleans or Houston. Those in the direct path of the coming ‘storm,’ like Governor Scott and Florida Senator Marco Rubio, have publicly shown their support for President Obama’s expedited funding request.

In Nicaragua, when people are hoping for something they desperately need, they say they’re hoping for it “como agua de mayo” (like the rains of May). But even more than I hoped for those cooling rains to finally start falling, I hope that U.S. leaders can quickly find ways to agree and earnestly join the urgent fight against the threat Zika poses to all Americans; South, Central, and North.

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